74021_H.L. Whtley_20190701

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0 . CAMA / DREDGE & FILL No. 74021 �*
GENERAL PERMIT =° �0�4�5 Previous permit# A F [lA C D
)C' New Modification LJComplete Reissue ❑Partial Reissue Date previous permit issued tJ '
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 7/ ' ' 2 0 ::_rh I •/1Jo •
U
l Rules attached.
Applicant Name P• - JJ J /T t.C/ Project Location: County 13 -t .-i-i'%vlz-7--- /� -
Address I QD / /J• A/F In-) ?8-- 2 , Street Address/State Road/Lot#(s) of F-S R„ /3/ cy
City ,oz.-0_5 ham-0 State r1-)LZI P -' ` 4{ C-� 3 k (v __:,., . ., 7 rA t , ; t;U.
Phone#(3/)) 9 O - 'Vl/(E-Mail Subdivision S1.,vr^1 -s••/4_, `-7—'
Authorized Agent T. -7 7 r/-►- -'� ` City j,,/R•7y-J-i�.l6 1D'J ZIP 2-ySs'1
Affected ❑CW JAEN, " PTA ❑ES ❑PTS Phone# ( g i�-_ ) -- River Basin -PANrz.,/I p
AEC(s): ElOEA ❑HHF 0 IH 0 UBA ❑N/A Adj.Wtr. Body , _ I v /4i v& (na /man /unkn)
❑PWS: -7�
ORW: yes /(no-Th PNA yes Closest Maj.Wtr. Body PA,� /(v �`'/+�
Type of Project/Activity -j D r x 6 2/6:2- ; X / i- 1-- i r ' . > l
-: uer. / 9 ' -- 5 3 t (Scale: / - 3) )
Pier(dock)length 9D y (e '
4V ae71
Fixed Platform(s) 7- �, ,
Floating Platform(s) _ - Al
) ...._Finger pier(s) \ I / - G1A-•L •lu J uF
Groin length ,
number -
Bulkhead/Riprap length I� i �- I •
avg distance offshore �� - u x ' 1t
max distance offshore � \ Is— �rt/, T, S.
-ii
Basin,channel I A.
1 4
cubic yards I _
Boat ramp - /,c.iii7r -rL
f
(Boathou;J . i i C ' --1 akr4U✓E 1
Beach Bulldozing l ; I
Other / I l
L - __.tr.�s.1.i� t� --•y am ' I
Shoreline Length -/2-D I L I L i-tr•-rt-el
SAV: not sure yes no _ ! .f
Moratorium: n/a yes no lil cJ,/rGbtiJ //-,Z 49 •
Photos: yes no I
Waiver Attached: yes> no I •
A building permit may be required by: 1.-- -4-t..i'F'- 7I w- See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) -?c __
Notes/Special Conditions / o'T J5 /v/-7,-- �� � L. *J , /\'�'�t/e F7 fP.X c)(?_5,- 5 , ?
r27 ?C.-' 7 f p 9M / n/p 5,-/ t ?: 57-rL Lr/',1/,L' f/1-'-1 r' /C'r-T'� /C7p � .2 A^(')","1"L M.
P-? ! p,1,,-•--) /e, '47,b D ^,k+1- 6 4,,-/ x-.41----v L"rz c�)..-- 0,&11 ,o p'7 ,/}-3 v ,a= 72 i-i.L .
-P f---eli- ---7;Pii/z-i )
Agent or Applicant Printed Name fficer's Pfint Name -
r /
Signature **Please read com fiance statement on back of permit�'"'F ignatur J
-7d C. i,1(_ �vo - I I d / �1 tiu� -Jv(� / /��E ^'�t7i2c)
Application Fee(s) Check# Issuing Date Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that I)prior to undertaking any activities authorized by this permit,the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief,certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar-Pamlico River Basin Buffer Rules Other:
Neuse River Basin Buffer Rules
If indicated on front of permit,your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the
Wilmington Regional Office(910-796-7215)for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ I-888-4RCOAST 252-946-6481
Fax: [phone] Fax: [phone]
(Serves:Carteret,Craven,Onslow- (Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet-and Pamlico Tyrrell and Washington Counties)
Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
Fax: [phone] (Serves: Brunswick, New Hanover,
(Serves:Camden,Chowan,Currituck, Onslow-South of New River Inlet-
Dare, Gates, Pasquotank and Perquimans and Pender Counties)
Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

06/24/2019 7:26 AM FAX [phone]
BERKELEY VETERINARY CLIN 0001/0005
I ;!
•
Authorized Agent Consent Agreement =
X t1 ,herby authorize Tobin Jay Tetterton of
(Property Owner(3))
TJ's Marine Construction,LLC to act on my behalf in obtaining CAMA permits for .
the location listed below.
PROPERTY ADDRESS:
3 40• S41MI1 LW knee.►t. !A.
� �f,�' teat P,. /Vt 2' lre
•
F �
PROPERTY OWNER'S MAILING ADDRESS:
1140 c) _))j-3o
•
Z
Phone No. /i qyq/ •
PROPERTY OWNER'S SIGNATURE: •
! ;.
AUTHORIZED AGENT SIGNATURE: /
O TETTERTON
DATE: :
; ,
20
: i
I,
!;
W/Authorized Agent Consent Agree.

I

06/24:2019 7: 26 AM FAX [phone] BERKELEY VETERINARY CLIP' 0002/0005
ADJACENT RIPARIAN PROPERTY-OWNER STATEMENT
I hereby certify that I own property adjacent to /q 2 Wg r/e J . 's
ame of Pro
( � �erty Owner)
props located at (.3e6 iiiV B/'t7 t"C1 ad
/, (Address, Lo
on aO tCo le:der , in (-54/ j>efri
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
loops_
Adjacent I have no objection to this proposal.
Property
owner I have objections to this proposal,
Check:one
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing developmw it must fill in description below or attach a site drawing)
/0,?(- Ra ti /n1
QeA6o
7Adeft
Zoo'," 4"P1-1
WAIVER SECTION
Adis`" understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
Property
Owrer must be set back a minimum distance of 15'from my area of riparian access unless waived by
M me. (If you wish to waive the setback, you,must initiat.the appropriate blank below.)
fnFt}al _ ft+ommtiErnm= =yr
One 14426 1 do wish to waive the 15'setback requirement.
I do not wish to waive the 15' setback requirement
(Property Owner Information) (Adjacent Property Owner Information)
Si: .,
/ w
Pri• • yp- - a, a � Print T e a
-'i i d. :ss Ma Addre
c"Y'sta 19 at(g 2 2 2_- 5$8
Tele nL Number!email-address
Telephone
IVu er/ marl address
Date Dale*
(Revised Aug.2014)
`Valid for one calendar year after signature•

r
06/24/2019 7:27 AM FAX [phone] BERKELEY VETERINARY CLIP Z 0003/0005
i
. ADJACENT RIPARIAN PROPERTY EIS TATEMENT
I herebycertify that 1 own property adjacent to /-/ ,,Z ��'J V .i/4'(7/e/y J/. 's -
• (Name of Property OQwner)
Property located at 3 o'G .5 a rr,m e r i/� ✓P n La N� T G✓yir olf 'V - �?8d 9
P P (Address, Lot, Block, Road,etc.) i
on �a,r keg /fve,, _ , in p& �bi'
N.C.
(Waterbody) (City/Town and/or unty)
The applicant has described to me, as shown below, the development proposed at the above
locatiopc-
Adizr.s.r..2
I have no objection to this proposal. ;
Praparty
OwnEr I have objections to this proposal.
Check eno
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
as n tleyela ent must> inj script on elor�+r'oir affa : i dle tlrawin
irldiiltit /plpP .. Pm :
/V‘i) Picer -4— f/4/169/9 .
•
•
-
'Gc . .e 40 . '
•
•
•
of' I :T f / I
tl7
•
•
WAIVER SECTION
cd;E c I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, Id, or groini. ,`
, must be set back a minimum distance of 15'from my area of riparian access unless waived by; ; ':
�•��,,.:
'- me. (If you wish to waive the setback, you 111W initial the appropriate blank below.) ;
rr_ig
OLa I do wish to waive the 15' setback requirement.
�32.-V I do not wish to waive the 15'setback requirement.
i
(Property Owner Information) (Adjacent Property Owner Information)
717- /ir ts-)-/ ill 6(1A0--- CoA,,c-t', r) .:
i :
Signature*
, 1
Signature.1. 1/1,04, fly y c•- A- 1,M KI nJ : _.
Print or Type Name Print gr Type Name �'(I I ,",� GI. 4_ , __& 3 � 0xw�t l'tJ4t dir--2J;_t _c_7.
Mailing Address /(� M U(/ �d s N CY- 7 '
City/State/Zip City/Stat
gi/9 q' iqf ' z 7 - 7 70& 7 ; l , ..
Telephone Nurrrber/e ail address Telephone umber email addre
Date
/ 7 Date*
(Raised Aug.2014
Valid for one calendar year after signature'

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: )4. t TLC\/
Date: 1.• --Z I c.
General Permit#:
14-c7 Z 1 '
Describe below the HABITAT disturbances for the application. All values should match the name,and units of measurement
found in your Habitat code sheet.
TOTAL Sq. Ft. FINAL Sq. Ft. TOTAL Feet FINAL Feet .
(Applied for. (Anticipated final (Applied for. (Anticipated final
DISTURB TYPE Disturbance total disturbance. Disturbance disturbance.
Habitat Name Choose One includes any Excludes any total includes Excludes any
anticipated restoration any anticipated restoration and/or
restoration or and/or temp restoration or temp impact
temp impacts) impact amount) temp impacts) amount)
', c-
1 y Dredge❑ Fill❑ Both ❑ Other ❑ i r'3`yL i 1 33-Z h -
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
•
Dredge❑ Fill❑ Both 0 Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill El Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑ •
Dredge❑ Fill❑ Both ❑ Other ❑
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